Ambulance
Your plan covers of 100% of the reasonable and customary charges per occurrence for licensed ground ambulance or emergency air service that transports the patient to the nearest hospital equipped to provide the required treatment when the physical condition of the patient prevents the use of another means of transportation. If the patient requires the services of a registered nurse during the flight, the services and return airfare for a registered nurse are covered. Limited to one trip per benefit year.
Practitioners
The services of the following practitioners are covered at 90% up to $40 per visit to a maximum of $300 based on reasonable and customary charges, per practitioner, per benefit year.
- Acupuncture
- Podiatrist^/Chiropodist
- Chiropractor^
- Massage Therapist *
- Dietitian
- Osteopath^
- Physiotherapist / Athletic Therapist *
- Speech Therapist
*physician’s prescription/referral required for indicated services
The services of the following practitioners are covered at 90% to an overall plan maximum of $900 based on reasonable and customary charges, per benefit year.
- Psychologist or Registered Social Worker
The services of the following practitioners are covered at 90% up to $75 per visit to a maximum of $300 based on reasonable and customary charges, per practitioner, per benefit year.
- Naturopathic Consultations
^If an X-ray is recommended, an additional $25 is covered towards this expense.
Medical Services & Supplies
It is recommended that an application for pre-approval be submitted to the insurer for any item that would be claimed under the Medical Services & Supplies benefit.
Your plan covers a maximum of $2000 per student benefit year for medical equipment and supplies.
Medical Equipment
Your plan covers a maximum of $2000 per student benefit year for eligible medical equipment when prescribed by a physician. Eligible durable equipment includes, but is not limited to, items such as:
• wheelchairs (repairs, $250 per lifetime);
• respiratory equipment, including oxygen, maximum $1,500 per student year
• contact lenses/glasses following cataract surgery limit 1 pair per lifetime
• canes, crutches, walkers, casts, splints catheters
• compression stockings limit 2 pairs per student year
• blood glucose monitor, maximum $500 per student year
• insulin pumps, maximum $500 per lifetime
• Intra-Uterine Devices with no medicinal content limit1 per student year
• aero chamber limit 1 per student year
• custom-made rigid or semi-rigid braces (not for athletic use) for back, neck, arm or leg, maximum $1,000 per lifetime, per condition
• non-dental prostheses such as artificial limbs and eyes; including replacement if required due to a change in physical condition
• Hearing aids covered at 50% up to $500 every five years
Braces, Crutches, Splints, Trusses
Your plan covers 80% of reasonable and customary charges when prescribed by a physician and are not solely for athletic use for braces, crutches, splints, and trusses.
Prosthesis
Your plan covers 80% of reasonable and customary charges when prescribed by a physician for artificial limbs or other prosthetic appliances.
Orthopaedics*
Your plan covers 80% up to a maximum of $150 per benefit year for custom-fitted orthopaedic shoes, repairs and modifications when required for the correction of deformity of the bones and muscles. Provided the orthopaedics are not solely for athletic use and are prescribed by a physician, podiatrist, chiropodist, or chiropractor.
*IMPORTANT It is strongly recommended that a pre-determination/estimate be submitted to Canada Life to ensure that the guidelines set out by Canada Life for the payment of Orthopaedics are met and to confirm that your claim would be eligible. |
Dental Accident
IMPORTANT! Dental Accident Pre-determination: An estimate for all dental accident services MUST be submitted to the health plan insurer. If you go ahead with treatment without a pre-determination being approved, you are doing so at the risk of the expenses being yours.
The plan covers 100% of the cost of the services of a dental surgeon, limited to the fees provided in the current General Practitioners fee guide, including dental prosthesis, required for the treatment of a fractured jaw or accidental injuries to natural teeth or jaw if caused by external, violent and accidental means. Services must be started within 90 days of accident and completed within 12 months of the accident. Dental Accident benefits are payable through the Health plan and limited to $1,000 per accident.